Hookah Bars

Hookah bars are emerging as an important consideration for smokefree air efforts in many communities. As more municipalities and states go 100% smokefree in workplaces, restaurants, bars, and casinos, establishments seeking to violate the law look for loopholes wherever they can. Most frequently, establishments claim to be "retail tobacco shops", by transforming themselves into hookah bars. If this tactic to skirt your smokefree law appears in your community, contact ANR for lessons learned and tips.

What is a hookah?

A hookah, also known as a narghile, shisha or hubble-bubble, is a waterpipe of Middle Eastern origin that is used to smoke sweet, often flavored, tobacco. The smoke is filtered through water in the base of the hookah's pipe. There is a common misconception that hookah smoke is less harmful than cigarette smoke, or not at all harmful, since the smoke passes through water before being inhaled or emitted as secondhand smoke. This is not true. The science shows that smoke from a hookah contains many of the same harmful and carcinogenic components as cigarette smoke. Hookahs should not be considered a safer alternative to cigarette smoking. Secondhand hookah smoke is not less harmful than secondhand cigarette smoke.

In 2005, the World Health Organization (WHO) issued an Advisory Note on Waterpipe Tobacco Smoking. This Advisory Note states:

  • "waterpipe smokers and second-hand smokers [are] at risks for the same kinds of disease as are caused by cigarette smoking, including cancer, heart disease, respiratory disease, and adverse effects during pregnancy."

  • And recommends that "waterpipes should be prohibited in public places consistent with bans on cigarette and other forms of tobacco smoking," and that "education…is urgently needed about the risks of waterpipe smoking, including high potential levels of secondhand exposure."

This chart lists chemicals found in hookah smoke versus cigarette smoke. Click on the image to enlarge.




How did the hookah fad start?

Hookah bars or cafes have been in the U.S. for many years, primarily in communities with Middle Eastern populations, and serve as social centers for many people. Traditional hookah establishments are not bars in the typical sense, as they primarily serve hookah-smoking and not alcohol-drinking patrons. In fact, most traditional hookah establishments do not serve alcohol at all, in keeping with Muslim practice.

However, hookah bars are gaining popularity around the U.S., particularly among college age individuals. Eighteen to 22-year-olds often find these establishments appealing for social reasons and because of the widespread misconception that there are reduced health risks associated with both active hookah smoking and secondhand hookah smoke. Hookah bars targeting the college age population often serve alcohol and can serve as an introduction to smoking among people who may not otherwise smoke.

Hookah News | Related Research

Hookahs: Gateway to Cigarettes?
MedPage Today - February 19, 2016

Young adult waterpipe tobacco ("hookah") smokers were more than twice as likely to try cigarettes than nonsmokers, a small cohort from the CDC's 2012-2013 ...

Pioneering study finds dangerous pollution levels in shisha bars [VIDEO]
Birmingham Newsroom - February 5, 2016

Revellers in shisha bars experience pollution levels higher than those in smog-hit Beijing, according to a report commissioned by Birmingham City Council the first UK study of its kind.

Secondhand smoke in hookah bars may put employees at risk
Indianapolis Recorder - January 29, 2016

Hookah bar employees are at risk for exposure to secondhand smoke, a new study warns. "Hookah [water pipe] use is often exempt from clean indoor-air laws ...

Hookah use rivals cigarette dangers
Johns Hopkins News-Letter - January 28, 2016

... As cigarette smoking rates fall, more people, especially teenagers and young adults in high school and college, are starting to smoke tobacco from hookahs. While there have been claims that smoking tobacco from a hookah is healthier than smoking cigarettes, a new meta-analysis shows that hookah smokers are still inhaling large amounts of toxicants.....

Secondhand Smoke in Hookah Bars May Put Employees at Risk
Philly.com - January 25, 2016

Hookah bar employees are at risk for exposure to secondhand smoke, a new study warns. "Hookah [water pipe] use is often exempt from clean indoor-air laws that protect people from secondhand smoke," study senior author Terry Gordon, a toxicologist and professor in the department of environmental medicine at NYU Langone Medical Center in New York City, said in an NYU news release.

One Hookah Session Delivers 25 Times the Tar of a Cigarette
ForexTV.com - January 11, 2016

PITTSBURGH, Pa., Jan. 11, 2016 (GLOBE NEWSWIRE) via PRWEB As cigarette smoking rates fall, more people are smoking tobacco from hookahscommunal pipes that enable users to draw tobacco smoke through water. A new meta-analysis led by the University of Pittsburgh School of Medicine shows that hookah smokers are inhaling a large load of toxicants. The findings, published online and scheduled for the January/February print issue of the journal Public Health Reports, represent a meta-analysis, or a mathematical summary of previously published data. The research team reviewed 542 scientific articles potentially relevant to cigarette and hookah smoking and ultimately narrowed them down to 17 studies that included sufficient data to extract reliable estimates on toxicants inhaled when smoking cigarettes or hookahs.

Hookah lounges banned in Concord
Contra Costa Times - November 4, 2015

The growing popularity of hookah smoking among young people led to the Planning ... open because they were approved before the council enacted the ban.

The Ugly Truths of Smoking Hookah
NewsHub.org - April 9, 2015

Smoking hookahs or wind pipes would go on to be a luxury of the upper class ... the city's indoor smoking ban, which prevents serving tobacco with sheesha.

VCU experts, colleagues explain dangers of hookah smoking
Augusta Free Press (Waynesboro, VA) - March 19, 2015

In an upcoming special supplement to the journal Tobacco Control, researchers from around the world will explain the past decade of research on waterpipe tobacco smoking - or what is commonly known as hookah, narghile or arghile smoking.

Water pipes can be more harmful than cigarettes: experts
Daily Mail - March 19, 2015

World health experts warned Thursday that smoking water pipes, long popular in the ... Brazil has taken measures to ban flavourings, while Turkey has extended ... And the ruler of the UAE emirate of Sharjah has banned the use of water pipes ...

Hookah causes Leukemia: study
Morocco World News - November 29, 2014

"Non-smokers who socialize with hookah [Shisha] smokers also inhale large quantities of charcoal combustion-generated toxic and carcinogenic emission," ...

Hookah, as Health Risk, Still Qualifies as Smoking
New York Times - November 25, 2014

Smoking through a hookah is not harmless, according to a new study. In addition to the usual tobacco carcinogens, dangerous levels of benzene are inhaled from the lump of smoldering charcoal that ignites the moist tobacco mixture.

Hookahs Deliver Toxic Benzene in Every Puff
HCPLive - November 25, 2014

Researchers analyzed levels of S-phenylmercapturic acid (SPMA) -- a metabolite of benzene --- in the urine of 105 hookah smokers and 103 nonsmokers ...

Hookah smokers and nonsmokers exposed to secondhand smoke ...
OregonLive.com - November 21, 2014

A new study has found that hookah smokers and those exposed to the secondhand smoke at social events face an increased risk of leukemia

Health Alert Hookah smoke dangers
KYTX - November 21, 2014

A study at San Diego State University found smoking tobacco from a hookah pipe ... Researchers say second hand smoke at hookah lounges is also a danger ...

Hookah Bars: Does the Smoking Ban Apply?
1011now - September 25, 2014

LINCOLN, Neb. -- A new Lincoln hookah bar attorney said the statewide smoking ban does not apply to his client's business. Rotana Club Hookah Bar opened ...

Hookah lounge violated permit conditions: VGN
The Island Now - September 25, 2014

The moratorium would allow the village to discuss possible restrictions on alternative forms of smoking, like hookah pipes and e-cigarettes that could pose public ...

Nearly 1 in 5 high school seniors have tried hookah
CNN Health - July 7, 2014

But if you ask young Americans about smoking tobacco through a hookah, also called a waterpipe or shisha, there's a good chance you won't find the same level of awareness. Some areas in the United States, like San Francisco, have curbed the practice. Roughly 73 municipalities and some states across the country have specifically banned hookah, says Bronson Frick, associate director of Americans for Nonsmokers' Rights.

Proposed Fayetteville ordinance could snuff out rapid growth of tobacco shops
Fayetteville Observer - June 1, 2014

A proposed ordinance before the Planning Coimmission would limit where developers could put tobacco shops, cigar bars and hookah lounges in the city.

Hookah bars have higher indoor air pollution
TheHealthSite - May 30, 2014

Air nicotine concentrations were also elevated and markedly higher than levels previously found in smoke-free bars and restaurants. (Read: Hookahs not a ...

Yes, College Students, Hookahs Are Bad for You
The Atlantic-by Olga Khazan - May 19, 2014

Almost twice as many high-school students smoke hookah as smoke e-cigarettes. A survey of eight North Carolina colleges found that 40 percent of students ...

Water pipe smoking causes significant exposure to nicotine and cancer-causing agents
Medical Xpress (PhysOrg.com) - May 16, 2014

Young adults who smoked water pipes in hookah bars had elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds (VOC) in their urine, and this may increase their risk for cancer and other chronic...

Study finds cigarette alternatives may not be safer than cigarettes
The Aggie - October 24, 2013

If youve ever been convinced to smoke hookah or anything else for that matter because someone told you it was completely safe, you arent alone (but youve been lied to). Are smoking alternatives as safe as people think? UC Davis pulmonary physicians recently published a study concluding these replacements can be addictive gateways to cigarette smoking. The assessment which focused on cigars, hookah, e-cigarettes and a Swedish smokeless tobacco called snus provides new insight on why people trying to quit smoking (and those who havent started) should avoid all types of tobacco products.

Cigarette alternatives may not be 'safe' tobacco
Medical Xpress - October 9, 2013

Cigarette alternatives, widely perceived to be safe, are often addictive and can be stepping stones to cigarette smoking, according to a scientific review published online in the journal Clinical Reviews in Allergy and Immunology.

County fines hookah lounges, orders them to curtail smoking
The Seattle Times (blog) - October 3, 2013

Citing the need to protect public health, King County officials have sent notices to six hookah lounges in Seattle ordering them to stop allowing patrons to smoke from water pipes on their premises. The move, covering hookah lounges scattered throughout the city, came after multiple inspections found violations of the states indoor-smoking ban passed by voters in 2005.

Medford city officials ban hookah bars
Wickedlocal-Med Ford - September 23, 2013

While Medford city officials will be working during the next six months to figure out where to put medical marijuana dispensaries, they have banned hookah bars. On Sept. 10, the Medford City Council approved a new ordinance banning hookah bars, or tobacco-smoking bars, from setting up shop within Medford's borders.

Hookah smoking delivers carcinogens and carbon monoxide
Science News - April 26, 2013

Compared with smoking cigarettes, using a hookah (shown) sends more carbon ... for four days and then, after a week with no restrictions, only cigarettes.

More Carbon Monoxide, Benzene In Hookah Smoke Than Cigarettes, Study Says
Nature World News - April 18, 2013

A lot of people scoff at cigarette smokers but will happily toke on a water pipe, or hookah, because it's more socially acceptable and even viewed as less hazardous than cigarettes. But a new study from the University of California, San Francisco reports that hookah smoke contains a different - but still harmful - cocktail of chemicals that can lead to health problems.

Ban intended for hookah lounges backfires
AberdeenNews.com - March 1, 2013

PIERRE ­ An attempt by Rapid City officials to have the Legislature make hookah lounges comply with the state’s smoking ban backfired Thursday. A House panel reversed the legislation, so that hookah lounges would be exempt if they were in actual operation before Jan. 1. Rep. Anne Hajek, R-Sioux Falls, warned a bigger door might be opening. “I think we’ve enlarged what liquor establishments can have smoking,” she said. The House Local Government Committee voted 8-4 to add the hookah exemption and send the new version of the bill to the full House of Representatives. It could be debated by House members as early as Tuesday afternoon. The original legislation brought by Sen. Craig Tieszen, R-Rapid City, sought to define smoking in state law. …

Senate OKs smoking definition to include hookah
Mitchell (SD) Daily Republic - Feb 16, 2013

He said the legislation will provide “a clear definition of smoking” that will allow all establishments to be treated in conformance with the state’s smoking ban. The vote was in favor 31-3. Voting no were Republican Ryan Maher of Isabel and Democrats A

Senate passes hookah lounge smoking bill
Rapid City (SD) Journal - Feb 15, 2013

A bill aimed squarely at hookah lounges sailed through the state Senate on Thursday. The bill, introduced by Sen. Craig Tieszen, R-Rapid City, changes the definition of smoking in state law to include the use of water pipes in hookah lounges, a point of ...

1 In 3 College Students Has Smoked Hookah
WCYB - June 7, 2012

… Unfortunately, smoking hookah delivers the same chemical compounds as smoking a cigarette. In fact, one session (usually about 45 to 60 minutes) delivers approximately 100 times the smoke as a single cigarette, with 40 times the tar and 10 times the carbon monoxide. ...

Hookah lounges under fire
The Clipper (WA) May 27, 2012

...Organizations like Americans for Nonsmokers' Rights (ANR) and smokefreewashington.com advocate against these hookah lounges as well as casinos that allow ...

Bill Banning Hookah and E-Cigarette Use Clears Another Hurdle
KCPW (blog) - February 27, 2012

(KCPW News) A bill banning the use of hookahs and e-cigarettes in public places under the Utah Indoor Clean Air Act will be debated by the full senate after ...

House passes ban on using e-cigarettes, hookahs in public
KSL-TV - February 23, 2012

The Utah House approved a proposal Tuesday to ban the smoking of hookah pipes and e-cigarettes in public places, after opponents held a hookah pipe smoking ...

Utah House committee OKs hookah ban
Salt Lake Tribune - February 9, 2012

By Robert Gehrke A House committee approved a bill Thursday banning the use of hookahs and electronic cigarettes in public places, but gave a five-year...

House panel forwards ban on hookah, e-cigarettes
Deseret News – February 9, 2012

Bradley Last, R-Hurricane, proposed to amend the state's Indoor Clean Air Act to define the use of electronic cigarettes and hookah pipes as smoking, ...

No more underage hookah smoking
Queens (NY) Chronicle - January 5, 2012

State legislation barring minors from hookah smoking or buying ... a few hookah bars prominently displayed signs banning anyone under 18 from entering. ...

Utah lawmakers: Smoking hookah OK in bars and clubs
Salt Lake Tribune, 2011-09-13
Heather May The Salt Lake Tribune

Utahns can continue to smoke tobacco from water pipes after all. ...

UTAH HOOKAH BAN: Controversial hookah ban goes into effect in Utah
KSTU-TV 13 (Salt Lake City, UT), 2011-09-12

A controversial ban on hookah bars in the state goes into effect today. ...

Are Hookah Bars Illegal?
Reuters - Stephanie Rabiner - August 30, 2011

For instance, Alabama has no statewide smoking ban, but a number of cities have implemented their own ban. Some allow smoking in restaurants and bars while ...

Utah gives hookah the hook
Salt Lake Tribune, 2011-08-29
HEATHER MAY The Salt Lake Tribune

Starting in mid-September, Utah bars and clubs cannot allow patrons to smoke most hookah products indoors. ...

Hookah bars are catching on in Rhode Island
Providence (RI) Journal-Bulletin, 2011-08-20
Andy Smith Journal Staff Writer

Hookah lounges arrived in Rhode Island in 2005. Instead of burning out, the fad appears to have grown increasingly popular, with a half-dozen hookah lounges on Federal Hill alone. ...

Show's over for San Francisco hookah lounges
San Francisco Chronicle, July 15, 2011

For hookah lounges in San Francisco, the end is very, very near. …

Hookah lounges: S.F. health officials seek closure
San Francisco Chronicle, 2011-07-12
Stephanie Lee, Chronicle Staff Writer

Public health department officials are threatening to shut down hookah lounges, whose owners, they say, have refused to obey state and local laws that ban indoor smoking, despite mailed and in-person warnings over the past year. ...

"Reducing hookah use: a public health challenge for the 21st century," BACCHUS Network, [2011].

This white paper report from the BACCHUS Network described the history of hookah use, its growing popularity among young people in the United States, the reasons for its popularity, marketing tactics by manufacturers, media coverage, health risks of use, attitudes to use, and tobacco policy to control use.

Utah health officials proposing rule to ban hookah smoking in public places, including bars
Associated Press (AP), 2011-06-06
JOSH LOFTIN Associated Press

A proposed rule by Utah health officials would prohibit hookah smoking in popular bars and other public places. ...

Madison County's ban on e-cigarettes, hookahs begins next Monday
Lexington Herald-Leader, May 31, 2011

Beginning Monday, June 6, Madison County will enforce an amended smoking ban that includes electronic cigarettes. The Madison County Board of Health voted in April to include e-cigarettes and hookahs (water pipes) in its indoor smoking restrict …

Putting a Crimp in the Hookah
New York Times - Douglas Quenqua - May 30, 2011

Most of the anti-hookah laws now under consideration are intended to end exemptions in state indoor-smoking bans that allowed hookah bars to thrive. Such bans often contained exceptions for “tobacco specialty shops”; many hookah bars qualify as such by ...

Hookah bar slips through legislative loophole
A bill in the Legislature would prevent new smoking lounges from opening
Eugene (OR) Register-Guard, 2011-05-22
Lauren Fox The Register-Guard

If Oregon lawmakers pass House Bill 2726, new hookah bars would be banned from opening, but the 62 existing lounges statewide plus any established before July would be grandfathered in. ...

Ore. lawmakers try to plug loophole allowing hookah lounges
Columbus (IN) Republic, 2011-05-22
* LAUREN FOX Eugene Register-Guard

Al Narah, Eugene's newest hookah lounge, may have opened in the nick of time. ...

Hookah bars, popular with teens, put on notice
NorthJersey.com - Zach Patberg - May 16, 2011

His application for an exemption to the smoking ban has stalled repeatedly. ... he said, adding that Eros ignored the smoking ban for the first year until ...

Hookahs Safer Than Cigarettes? A Pipe Dream
Toking on Water Pipes Gaining in Popularity, but Full of Health Risks
MedicineNet, 2011-05-10
Bill Hendrick WebMD Health News

Lots of people who quit cigarettes to escape the dangers of nicotine are turning to water pipe smoking, wrongly assuming that toking on "hookahs" is safer, new research indicates. ...

Hookah Lounge Ban Narrowly Passes Committee Vote
WFSB Hartford - May 10, 2011

A bill that would ban smoking in Connecticut hookah lounges, except those establishments that opened last year or earlier, has narrowly cleared a key legislative committee. The Planning and Development Committee passed the bill Monday on an 11-10 vote. ...

Hookah Lounges Face Possible Changes
A Bill Up For Vote Could Adopt New Regulations
Associated Press (AP), 2011-05-08

A bill that prohibits smoking in Connecticut hookah lounges, except those open before the end of last year, is facing a key legislative vote. ...

House Votes to Place Restrictions on Hookah Bars
The Lund Report - Amanda Waldroupe - April 27, 2011

The bill closes a loophole in the Clean Indoor Air Act, also known as the Smoke-Free Workplace Law, which allows the sampling of tobacco products at smoke shops and cigar bars for 'retail decision-making.' Tomei said the loophole allows hookah lounges ...

Study Reveals Higher CO Levels With Hookah Smoking
MD News (press release) - Jill Pease - April 8, 2011

The next step would be to demonstrate harmful exposures in those working in non-smoke free venues or patrons of such venues who are nonsmokers.” ­ Wasim Maziak, MD, Ph.D., Professor at the University of Memphis School of Public Health, Director of the ...

Hookah Use Widespread Among College Students Study Reveals Mistaken Perception ...
Newswise (press release) - April 5, 2011

Newswise ­ WINSTON-SALEM, NC – April 5, 2011 – Despite a growing number of cities instituting smoking bans across the country, hookah bars are cropping up everywhere – from chic downtown cafes to locations near college campuses, where they've found a ...

City Councilman wants to ban creation of new hookah bars in city, says smoke is dangerous
New York Daily News, 2010-10-25
Irving Dejohn and Erin Durkin DAILY NEWS WRITERS

A lawmaker wants to snuff out the growth of the city's hookah bars - saying herbal smoke from the lounges' water pipes is just as dangerous as cigarettes.

City Councilman Vincent Gentile (D-Brooklyn) will press this week to extend a smoking ban to include all smoking, including now-legal herbal shisha smoke from hookahs.

Existing hookah bars would be exempt, but new indoor ones would be banned in 2012. The dozens already open would have to register with the city Health Department, and wouldn't be able to expand or change locations.

Gentile argues that hookah smoke, which contains tar and carbon monoxide, can be just as dangerous as cigarettes. ...

Utah County OKs hookah policy
Salt Lake Tribune - Donald W. Meyers - September 27, 2010

Provo • To the Utah County Board of Health, hookah pipes are the same as cigarettes and cigars.

The board unanimously voted Monday to adopt a policy treating hookah pipes like any other tobacco product, fully subject to the Indoor Clean Air Act.

The policy will act as a placeholder. It’s expected the state Department of Health will issue an administrative rule declaring hookah pipes subject to Utah’s indoor-smoking law.

Joseph Miner, Utah County Health Department’s executive director, said the county is following the lead of Davis County, which recently enacted an identical policy.

“We’re doing what common sense tells us,” Miner said. “But until the state acts, we need some guidelines." ...

Hope for hookah bars in Davis County goes up in smoke
Davis County (UT) Clipper, 2010-08-12
Melinda Williams

FARMINGTON ­ Before any hookah bars open in the county, the Davis County Board of Health plans on halting them at the border by using the state’s Clean Air Act.

The board gave a directive to health department director Lewis Garrett to put together a policy which would ban such establishments because of the effects of second-hand smoke hookahs would generate. . . .

Sam North, a health educator with the county, told board members that for many, smoking a hookah is a social event.

Hookah bars are gaining in popularity in the United States, especially among college-age students. Here in Utah there are such bars in Salt Lake County and elsewhere. Utah County is looking at its first.

North told board members that statistics from studies conducted in 2005 and 2006 for a national Tobacco-Related Disease Program, show that those smoking hookahs get 72 times the tar, four times the nicotine and 11 times the carbon monoxide of those smoking cigarettes. ...

ESCONDIDO: City rejects proposal to allow hookah lounges
Council cites concerns about health, attracting wrong crowd
North County (CA) Times, 2009-12-03

The City Council decided Wednesday not to allow hookah smoking lounges in Escondido, asserting that such businesses would not attract the appropriate crowd to downtown, might jeopardize the health of teens and could burden the Police Department.

The move comes in response to at least four inquiries the city has received this fall from entrepreneurs seeking to fill North County's void of hookah lounges, where customers smoke flavored tobacco through communal pipes.

Area residents have been forced to travel to Sorrento Valley or San Diego's Gaslamp District to smoke hookah pipes in a public setting since the only lounge in North County, Hubbly Bubbly in San Marcos, closed about a year ago.

Proponents have said that allowing such lounges in Escondido could reduce the growing number of downtown vacancies, help fill the city's void of activities for young people, bring new energy to Grand Avenue and possibly bolster nearby restaurants and retail shops.

Councilman Sam Abed and Councilwoman Olga Diaz said they were open to allowing hookah lounges if the city adopted significantly tougher restrictions than other cities have ...

Waterpipe tobacco smokers inhale same toxicants as cigarette smokers
ScienceDaily, 2009-12-03

Smoking tobacco through a waterpipe exposes the user to the same toxicants -- carbon monoxide and nicotine -- as puffing on a cigarette, which could lead to nicotine addiction and heart disease, according to a study led by a Virginia Commonwealth University researcher published in the December issue of the American Journal of Preventive Medicine.
In the past eight to 10 years, smoking tobacco with a waterpipe, also called a hookah or shisha, has grown in popularity in the United States, especially among adults 18 to 24. The belief among some waterpipe users is that this method of smoking tobacco delivers less tar and nicotine than regular cigarette smoking and has fewer adverse health effects.

"The results are important because they provide concrete, scientific evidence that contradicts the oft-repeated myth that waterpipe tobacco smoking does not involve users inhaling the same harmful chemicals that cigarette smokers do," said principal investigator Thomas Eissenberg, Ph.D., professor in the VCU Department of Psychology.

"We hope that these results will be used by physicians and public health officials to inform waterpipe tobacco smokers that they risk tobacco-induced nicotine addiction and cardiovascular disease," he said.

Toback: Smoking hookah not worth the health risk - Feature
Daily Orange (Syracuse University), 2009-11-19
Rebecca Toback

Smokers who think that trying hookah as a healthier alternative to cigarettes are way off base. Hookah smokers inhale a greater volume of smoke, worsening the effects of the chemicals in the tobacco.

"Data from several different countries reveals that “a single hookah-use episode lasts for about 45 minutes and can easily involve over 100 puffs," said Thomas Eissenberg, professor of psychology at Virginia Commonwealth University, whose research is funded by a grant for the National Cancer Institute.

"Each puff is about 500 ml in volume, while a single cigarette-use episode lasts about 5 minutes and can involve about 10-12 puffs of about 30-50 ml each. We are talking 100 times the smoke inhalation for a hookah-use episode, 50,000 ml total volume relative to a “single cigarette-use episode, 500 ml total volume." . .

While it is widely known that cigarette smoking is bad for your health, hookah is possibly even worse. Hookah smoking is becoming popular across the country with hookah cafes opening up in many cities. Last semester, a hookah bar opened on Marshall Street but closed after just a few months. I guess the cost to expose one's self to cancer must have not worked well in this economy. ...

Bay Area hooked on hookah
San Francisco Chronicle, 2009-10-18
Carolyne Zinko, Chronicle Staff Writer

Across the Bay Area and nation in recent years, hookah lounges have become increasingly popular gathering places for college students too young to drink legally, transplanted Middle Easterners looking to indulge in a familiar pastime and even for veterans of the Iraq war, who learned to enjoy hookahs while overseas. The practice is believed to have originated in India and spread to the Middle East hundreds of years ago.
Hookah lounges in the Bay Area tend to cluster around universities such as Stanford, although there are many in San Francisco - from the Tenderloin to the Haight-Ashbury. High-tech workers and engineers such as Mohammad Aldossary, 25, a Stanford graduate student in petroleum engineering from Saudi Arabia, enjoy them, too.

"It's more fun to be in the social atmosphere here," he said at Da Hookah Spot. "I don't smoke cigarettes, but I smoke from a hookah pipe once or twice a week."

The lounges are often classified as tobacco shops, allowing them to get around California's 1998 statewide ban on smoking in bars. Most cities prohibit the sale of food in such establishments. The sale of nonalcoholic beverages, however, is typically allowed as long as they do not make up a significant portion of revenues, and alcohol is prohibited, according to officials at the city attorney's offices in Palo Alto, Hayward and San Francisco.

Worth waves goodbye to hookah bars
Reporter Online - William Jones - Oct 8, 2009

The statewide smoking ban outlawed smoking at bars and restaurants, but lighting up was still legal at businesses people would go for the sole purpose of ...

Sorry, hookah bar, no smoking
The Bryan-College Station Eagle, October 9, 2009

The College Station City Council decided Thursday not to make an exception to the city's smoking ordinance for a hookah bar. Hookah Station in the Northgate district had requested an exclusion from the city ordinance that was revised early this year ...

Sheesha smokers at high risk of catching virus
TradeArabia (bh), 2009-09-15

Sheesha smokers could be contributing to the spread of the swine flu, it has been claimed.

According to the Bahrain Anti-Smoking Society, sheesha pipes are an ideal tool for users to catch the virus since they are often passed from person to person.

'This is a real threat and all sheesha users should be careful,' said society vice-president Dr Kadhem Al Halwachi.

'We have already been told smokers are at an increased risk of getting complications from the swine flu because a smoker's lungs are already compromised.'

Health officials last week added smokers to a list of 'high risk' individuals who could contract the H1N1 virus. ...

It's no to hookah bars, yes to tattoos in Menifee
Riverside (CA) Press-Enterprise, 2009-08-26
JULISSA McKINNON The Press-Enterprise

The Menifee Planning Commission started tackling the question on Tuesday of how to regulate hookah lounges, tattoo parlors and cell phone towers, all of which are temporarily banned in the city.

After recommending a ban on hookah lounges, most commissioners leaned in favor of allowing but tightly regulating, tattoo and body piercing parlors.

Four of the five commissioners expressed reservations about hookah lounges, saying they could promote smoking or encourage crime or "smoking other things," as Commissioner Marc Miller put it.

Commissioner Bill Zimmerman supported allowing hookah lounges "in the interest of being fiscally sound."

"If Menifee wants to send a message to the public that we are business friendly, an outright ban on certain businesses might not send the right message," he said. ...

Shisha 'as harmful as cigarettes'
BBC Online, 2009-08-24
Perminder Khatkar BBC Asian Network

Smoking a shisha pipe is as bad for people as smoking tobacco, the Department of Health and the Tobacco Control Collaborating Centre has found.

People who smoke shisha, or herbal tobacco, can suffer from high carbon monoxide levels, its research revealed.

It found one session of smoking shisha resulted in carbon monoxide levels at least four to five times higher than the amount produced by one cigarette.

High levels of carbon monoxide can lead to brain damage and unconsciousness. . . .

The study found shisha smokers had 40-70 ppm of CO in their breath - affecting 8-12% of their blood.

Dr Hilary Wareing, director of the Tobacco Control Collaborating Centre, told the BBC's Asian Network she was shocked by the results of the research. . . .

"You never see it in the news - 'that is terrible, don't do it' - there's no shock tactics like (there is with) cigarettes," said one young woman.
"If my mum sees me smoking shisha, she isn't going to take it as seriously as if I was smoking cigarettes," said a British Pakistani man.

It was this misconception - and finding dangerous levels of carbon monoxide in a pregnant woman who had stopped smoking tobacco, but continued to smoke shisha - which prompted the research.

"We found one session of smoking shisha - that's 10 milligrams (of fruit tobacco) for 30 minutes - gave carbon monoxide levels that were at the lowest four and five times higher than having a cigarette," said Dr Wareing. ...

No Exemption for Hookah Bars
WHQR Public Radio - Michael Tomsic - August 4, 2009

A bill to exempt hookah bars from the North Carolina smoking ban was withdrawn from the House at the request of hookah bar owners.
The bill had passed two committees when hookah bar owners from Watauga and Orange Counties asked Watauga County Democrat Cullie Tarleton to pull it. Tarleton, the bill's primary sponsor, says the issue will not be reopened during this legislative cycle.

"I tried to make it very clear that our window of opportunity was now, which was last week, and once the decision was made not to go forward with the bill, that killed it for this session."

Tarleton says the owners asked him to withdraw the bill because of amendments that would greatly restrict their businesses. ...

Survey of Hookah Establishments in North Carolina
Prepared by NC Prevention Partners, July, 2009

After the successful passage of a statewide law to prohibit smoking in all NC restaurants and bars, discussion of the law’s impact on hookah bars was brought up by legislators and hookah establishment owners. This report provides a description of hookah, the health impact of hookah use, and results of a survey of hookah establishments in North Carolina. ...

New law may put flames out at Wilmington Hookah Bars
WECT 6 WILMINGTON(NC), 2009-07-29

Wilmington is home to about one-fifth of all hookah bars in North Carolina, but the state smoking ban would effectively put them all out of business.

A bill approved Tuesday by a judiciary committee could change the rules for hookah bars like Wilmington's Juggling Gypsy on Castle Street.
"We've been very active with other hookah bars in the state," said Denny Best, Juggling Gypsy manager. "We're trying to get an amendment passed to exempt hookah bars like they plan to exempt cigar bars." ...

Exception for hookah bars OK'd by NC House panel
North Carolina House committee agrees to exempt existing hookah bars from smoking ban
AP, 2009-07-29

Establishments where patrons smoke tobacoo using a water pipe could remain open in North Carolina in legislation heading to the full House.
A judiciary committee Tuesday evening narrowly approved a bill to allow hookah bars open as of July 1 to keep selling after a new smoking ban in bars and restaurants takes effect next year. ...

Santa Cruz bans hookah lounges near kid hot spots
San Jose (CA) Mercury-News, 2009-05-13
Genevieve Bookwalter - Sentinel staff writer

City leaders cracked down on hookah lounges Tuesday night, saying the couch-filled shops that sell sessions with flavored tobacco and a water pipe need to stay away from schools, and that only one more will be allowed within city limits.

"It occurred to us that this was really more of a public health issue," said City Attorney John Barisone. "This particular type of business appeals to young people."

Right now only one hookah lounge, Smoke This! Hookah Lounge next to the Teen Center on Laurel Street, is open in Santa Cruz. That's down from a height of three in 2007. While Smoke This! will be grandfathered in until the year 2014, new rules will not allow lounges within 1,000 feet of schools, parks or recreation centers. ...

Heights leader hopes to curb hookah use among minors
Dearborn Press and Guide - April 1, 2009

By Sean Delaney , Press & Guide Newspapers The Dearborn Heights City Council is working on an amendment to the city ordinance on minors in possession of ...

Hookah, chillum smoking more toxic than cigarette: Study
The Times of India, 2008-10-02

JAIPUR: Traditional hookah and chillum are more injurious to health than cigarette, a study has said.

The study underlines that the old mode of smoking is much more toxic than cigarette smoke as carbon monoxide (CO) level is higher in it, the study conducted by a group of pulmonary doctors of the SMS Hospital Medical College and the Asthma Bhawan here said.

The study assumes significance in the wake of ongoing debates on the ill effects of smoking and the countrywide ban on lighting up the rolled tobacco at public places, which came into force on Thursday.

Professor of medicine Virendra Singh, who was a part of the study claims that the traditional smoking ways can be fatal.

Waterpipe Smoking on College Campuses May Contribute to Growing Public Health Problem
Health News Digest, 2008-05-06
Virginia Commonwealth University

More and more U.S. college students are smoking tobacco using waterpipes – or hookahs – and it’s becoming a growing public health issue, according to a new study led by a Virginia Commonwealth University researcher.

The findings offer important insight into the prevalence and perceptions related to waterpipe tobacco smokers and are reported in the May issue of the Journal of Adolescent Health. The article is also featured in an editorial in the same issue.

“These results should serve as an alarm bell to anyone interested in public health in the United States. Preventing tobacco-caused death and disease means remaining alert to new forms of tobacco smoking and then understanding the health risks of these new forms and communicating these risks to public health workers, policy makers, and to smokers themselves,” said principal investigator Thomas Eissenberg, Ph.D., associate professor in the VCU Department of Psychology. . . .

EGYPT: Water pipe smoking a significant TB risk
Integrated Regional Information Network (IRIN), 2008-03-24

The smoking of the traditional `shisha' water pipe is increasingly emerging as a significant health risk in Egypt, due to air-borne tuberculosis (TB) transmission from pipe sharing and uncontrolled, manual preparation of the pipe.

Rania Siam, professor of microbiology at the American University in Cairo (AUC), said the most important risk factor for TB infection was close household contact with a TB case, but she said water pipe smoking (WPS) and the sharing of the pipe with someone with pulmonary TB led to a great risk of TB transmission, especially among young adolescents.

"`Shisha' [smoking] is Egyptian culture, where people smoke tobacco and inhale directly from this device. If I smoke `shisha', some bacteria may reside in it.

Health officials warn of hookah-smoking hazard: Two CSU students contracted oral herpes
Fort Colliins (CO) Coloradoan, 2008-03-18

Cases of two Colorado State University students who might have contracted oral herpes from recent trips to a hookah bar are prompting health officials to remind people of the dangers of sharing saliva.

Anything from mononucleosis to an infectious cold sore can be passed through sharing soft drinks or passing around a mouthpiece at a hookah smoking session. "People shouldn't share spit," said Paul Poduska, infections control coordinator at Poudre Valley Hospital.

Hookah News | Related Research
Barnett, T.E.; Livingston, M.D., "Hookah use among adolescents: differential cognitions about hookah and cigarettes," Addictive Behaviors 75: 75-78, December 2017.
Travers, M.J.; Kulak, J.A.; Vogl, L., "Waterpipe cafés are hazardous to your health: determination of a waterpipe specific calibration factor," International Journal of Hygiene and Environmental Health [Epub ahead of print], October 12, 2017.
Weitzman, M.; Yusufali, A.H.; Bali, F.; Ruzmyn Vilcassim, M.M.; Gandhi, S.; Peltier, R.; Nadas, A.; Sherman, S.; Lee, L.; Hong, Z.; Shearston, J.; Hyun Park, S.; Gordon, T., "Effects of hookah smoking on indoor air quality in homes," Tobacco Control 26(5): 586-591, September 2017.
Kassem, N.O.F.; Kassem, N.O.; Liles, S.; Zarth, A.T.; Jackson, S.R.; Daffa, R.M.; Chatfield, D.A.; Carmella, S.G.; Hecht, S.S.; Hovell, M.F., "Acrolein exposure in hookah smokers and non-smokers exposed to hookah tobacco secondhand smoke: implications for regulating hookah tobacco products," Nicotine and Tobacco Research [Epub ahead of print], June 7, 2017.
Moon, K.A.; Rule, A.M.; Magid, H.S.; Ferguson, J.; Susan, J.; Sun, Z.; Torrey, C.; Abubaker, S.; Levshin, V.; Çarkoglu, A.; Radwan, G.N.; El-Rabbat, M.; Cohen, J.E.; Strickland, P.; Breysse, P.N.; Navas-Acien, A., "Biomarkers of secondhand smoke exposure in waterpipe tobacco venue employees in Istanbul, Moscow, and Cairo," Nicotine and Tobacco Research [Epub ahead of print], June 3, 2017.
Juhasz, A.; Pap, D.; Barta, I.; Drozdovszky, O.; Egresi, A.; Antus, B., "Kinetics of exhaled carbon monoxide after water-pipe smoking indoors and outdoors," Chest 151(5): 1051-1057, May 2017.
Cohn, A.M.; Ehlke, S.J.; Cobb, C.O.; Soule, E.K., "Hookah tobacco smoking in a large urban sample of adult cigarette smokers: links with alcohol and poly-tobacco use," Addictive Behaviors 68: 1-5, May 2017.
Lopez, A.A.; Eissenberg, T.; Jaafar, M.; Afifi, R., "Now is the time to advocate for interventions designed specifically to prevent and control waterpipe tobacco smoking," Addictive Behavior 66: 41-47, March 2017.
Yillmaz, S.G.; Llerena, A.; De Andrés, F.; Karakas, Ü.; Gündogar, H.; Erciyas, K.; Kimyon, S.; Mete, A.; Güngör, K.; Özdemir, V., "Water pipe (shisha, hookah, arghile) smoking and secondhand tobacco smoke effects on CYP1A2 and CYP2A6 phenotypes as measured by caffeine urine test," OMICS 21(3): 177-182, March 2017.
Leavens, E.L.; Brett, E.; Frank, S.; Shaikh, R.A.; Leffingwell, T.R.; Croff, J.M.; Wagener, T.L., "Association between breath alcohol concentration and waterpipe lounge patrons' carbon monoxide exposure: a field investigation," Drug and Alcohol Dependence 170: 152-155, January 1, 2017.
Zhou, S.; Behrooz, L.; Weitzman, M.; Pan, G.; Vilcassim, R.; Mirowsky, J.E.; Breysee, P.; Rule, A.; Gordon, T., "Secondhand hookah smoke: an occupational hazard for hookah bar employees," Tobacco Control 26(1): 40-45, January 2017.
Majeed, B.A.; Sterling, K.L.; Weaver, S.R.; Pechacek, T.F.; Eriksen, M.P., "Prevalence and harm perceptions of hookah smoking among U.S. adults, 2014-2015," Addictive Behaviors 69: 78-86, January 2017.
Fedele, D.A.; Barnett, T.E.; Dekevich, D.; Gibson-Young, L.M.; Martinasek, M.; Jagger, M., "Prevalence of and beliefs about electronic cigarettes and hookah among high school students with asthma," Annals of Epidemiology 26(12): 865-869, December 2016.
Kim, K.H.; Kabir, E.; Jahan, S.A., "Waterpipe tobacco smoking and its human health impacts," Journal of Hazardous Materials 317: 229-236, November 5, 2016.
Elsayed, Y.; Dalibalta, S.; Abu-Farha, N., "Chemical analysis and potential health risks of hookah charcoal," Science of the Total Environment 569-570: 262-268, November 1, 2016.
Bahelah, R.; DiFranza, J.R.; Ward, K.D.; Fouad, F.M.; Eissenberg, T.; Ben Taleb, Z.; Jaber, R.; Osibogun, O.; Maziak, W., "Correlates of nicotine dependence among adolescent waterpipe smokers," Drug and Alcohol Dependence [Epub ahead of print], November 1, 2016.
Salloum, R.G.; Asfar, T.; Maziak, W., "Toward a regulatory framework for the waterpipe," American Journal of Public Health 106(10): 1773-1777, October 2016.
Wagoner, K.G.; Cornacchione, J.; Wiseman, K.D.; Teal, R.; Moracco, K.E.; Sutfin, E., "E-cigarettes, hookah pens and vapes: adolescent and young adult perceptions of electronic nicotine delivery systems," Nicotine and Tobacco Research 18(10): 2006-2012, October 2016.
Park, S.H.; Duncan, D.T.; El Shahawy, O.; Shearston, J.A.; Lee, L.; Tamura, K.; Sherman, S.E.; Weitzman, M., "Analysis of state-specific prevalence, regional differences, and correlates of hookah use in U.S. adults, 2012-2013," Nicotine and Tobacco Research [Epub ahead of print], September 9, 2016.
Ramôa, C.; Shihadeh, A.; Salman, R.; Eissenberg, T., "Group waterpipe tobacco smoking increases smoke toxicant concentration," Nicotine and Tobacco Research 18(5): 770-776, May 2016.
Gurung, G.; Bradley, J.; Delgado-Saborit, J.M., "Effects of shisha smoking on carbon monoxide and PM2.5 concentrations in the indoor and outdoor microenvironment of shisha premises," Science of The Total Environment 548-549: 340-346, April 1, 2016.
Zhou, S.; Behrooz, L.; Weitzman, M.: Pan, G.; Vilcassim, R.; Mirowsky, J.E.; Breysee, P.; Rule, A.; Gordon, T., "Secondhand hookah smoke: an occupational hazard for hookah bar employees," Tobacco Control [Epub ahead of print], January 25, 2016.
Colditz J.B.; Ton, J.N.; James, A.E.; Primack, B.A., "Toward effective water pipe tobacco control policy in the United States: synthesis of federal, state, and local policy texts," American Journal of Health Promotion [Epub ahead of print], January 5, 2016.
Noland, M.; Ickes, M.J.; Rayens, M.K.; Butler, K.; Wiggins, A.T.; Hahn, E.J., "Social influences on use of cigarettes, e-cigarettes, and hookah by college students,"
Journal of American College Health [Epub ahead of print], January 2016.

Zhou, S.; Weitzman, M.; Vilcassim, R.; Wilson, J.; Legrand, N.; Saunders, E.; Travers, M. ; Chen, L.C.; Peltier, R.; Gordon, T., "Air quality in New York City hookah bars," Tobacco Control 24(e3): e193-e198, October 2015.

Al Mulla, A.; Fanous, N.; Seidenberg, A.B.; Rees, V.W., "Secondhand smoke emission levels in waterpipe cafes in Doha, Qatar," Tobacco Control 24(e3): e227-e231, October 2015.
Munshi, T.; Heckman, C.J.; Darlow, S., "Association between tobacco waterpipe smoking and head and neck conditions: a systematic review," Journal of the American Dental Association 146(10): 760-766, October 2015.
Kates, F.R.; Salloum, R.G.; Thrasher, J.F.; Islam, F.; Fleischer, N.L.; Maziak, W., "Geographic proximity of waterpipe smoking establishments to colleges in the U.S.," American Journal of Preventive Medicine [Epub ahead of print], September 5, 2015.
Medford, M.A.; Gasier, H.G.; Hexdall, E.; Moffat, A.D.; Freiberger, J.J.; Moon, R.E., "Research report: charcoal type used for hookah smoking influences CO production," Undersea & Hyperbaric Medicine 42(4): 375-380, July 2015.
Wang, L.W.; He, E.Y.; Ghosh, D.; Day, R.O.; Jones, G.R.; Subbiah, R.N.; Holloway, C.J., "Severe carbon monoxide poisoning from waterpipe smoking: a public health concern," Medical Journal of Australia 202(8): 446-447, May 4, 2015.
Barnett, T.E.; Soule, E.K.; Forrest, J.R.; Porter, L.; Tomar, S.L., "Adolescent electronic cigarette use: associations with conventional cigarette and hookah smoking," American Journal of Preventive Medicine [Epub ahead of print], March 31, 2015.
Amrock, S.M.; Gordon, T.; Zelikoff, J.T.; Weitzman, M., "Hookah use among adolescents in the United States: results of a national survey," Nicotine and Tobacco Research 16(2): 231-237, February 2014.
Ishtiaque, I.; Shafique, K.; Ul-Haq, Z.; Shaikh, A.R.; Khan, N.A.; Memon, A.R.; Mirza, S.S.; Ishtiaque, A., "Water-pipe smoking and albuminuria: new dog with old tricks," Plos One 9(1): e85652, January 17, 2014.
Lee, Y.O.; Hebert, C.J.; Nonnemaker, J.M.; Kim, A.E., "Multiple tobacco product use among adults in the United States: cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus," Preventive Medicine [Epub ahead of print], January 16, 2014.
Lee, Y.O.; Bahreinifar, S.; Ling, P.M., "Understanding tobacco-related attitudes among college and noncollege young adult hookah and cigarette users," Journal of American College Health 62(1): 10-18, January 2014.
Barnett, T.E.; Forrest, J.R.; Porter, L.; Curbow, B.A., "A multiyear assessment of hookah use prevalence among Florida high school students," Nicotine and Tobacco Research [Epub ahead of print], December 17, 2013.
Sidani, J.E.; Shensa, A.; Barnett, T.E.; Cook, R.L.; Primack, B.A., "Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: a longitudinal study of university students," Nicotine and Tobacco Research [Epub ahead of print], December 9, 2013.
Jukema, J.B.; Bagnasco, D.E.; Jukema, R.A., "Waterpipe smoking: not necessarily less hazardous than cigarette smoking: possible consequences for (cardiovascular) disease," Netherlands Heart Journal [Epub ahead of print], December 5, 2013.
Shihadeh, A.; Eissenberg, T.; Rammah, M.; Salman, R.; Jaroudi, E.; El-Sabban, M., "Comparison of tobacco-containing and tobacco-free waterpipe products: effects on human alveolar cells," Nicotine and Tobacco Research [Epub ahead of print], December 3, 2013
CDC, "Tobacco product use among middle and high school students — United States, 2011 and 2012," Morbidity and Mortality Weekly Report 62(45): 893-897, November 15, 2013.
Jawad, M.; McEwen, A.; McNeill, A.; Shahab, L., "The importance of addressing waterpipe tobacco smoking: research and policy responses," Addiction 108(11): 1887-1888, November 2013.
Maynard, O.M.; Gage, S.H.; Munafo, M.R., "Are waterpipe users tobacco-dependent?," Addiction 108(11): 1886-1887, November 2013.
Eissenberg, T.,"What can waterpipe tobacco smoking teach us about the need for a more rapid response to emerging non-communicable disease risks?," Addiction 108(11): 1885-1886, November 2013.
Hammal, F.; Chappell, A.; Wild, T.C.; Kindzierski, W.; Shihadeh, A.; Vanderhoek, A.; Huynh, C.K.; Plateel, G.; Finegan, B.A., "'Herbal' but potentially hazardous: an analysis of the constituents and smoke emissions of tobacco-free waterpipe products and the air quality in the cafes where they are served," Tobacco Control [Epub ahead of print], October 15, 2013.
Kassim, S.; Al-Bakri, A.; Al'absi, M.; Croucher, R., "Waterpipe tobacco dependence in U.K. male adult residents: a cross-sectional study," Nicotine and Tobacco Research [Epub ahead of print], October 15, 2013.
Cobb, C.O.; Vansickel, A.R.; Blank, M.D.; Jentink, K.; Travers, M.J.; Eissenberg, T., "Indoor air quality in Virginia waterpipe cafés," Tobacco Control 22(5): 338-343, September 2013.
Al Ali, R.; Rastam, S.; Ibrahim, I.; Bazzi, A.; Fayyad, S.; Shihadeh, A.L.; Zaatari, G.S.; Maziak, W., "A comparative study of systemic carcinogen exposure in waterpipe smokers, cigarette smokers and non-smokers," Tobacco Control [Epub ahead of print], August 29, 2013.
Heinz, A.J.; Giedgowd, G.E.; Crane, N.A.; Veilleux, J.C.; Conrad, M.; Braun, A.R.; Olejarska, N.A.; Kassel, J.D., "A comprehensive examination of hookah smoking in college students: use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use," Addictive Behaviors 38(11): 2751-2760, July 23, 2013.
Jawad, M.; Bakir, A.M.; Ali, M.; Jawad, S.; Akl, E.A., "Key health themes and reporting of numerical cigarette-waterpipe equivalence in online news articles reporting on waterpipe tobacco smoking: a content analysis," Tobacco Control [Epub ahead of print], July 18, 2013.
Jawad, M.; McEwen, A.; McNeill, A.; Shahab, L., "To what extent should waterpipe tobacco smoking become a public health priority?," Addiction [Epub ahead of print], July 17, 2013.
Akl, E.A.; Jawad, M.; Lam, W.Y.; Co, C.N.; Obeid, R.; Irani, J., "Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review," Harm Reduction Journal 10(1): 12, July 2, 2013.
Ozkan, S.; Ozturk, T.; Ozmen, Y.; Durukan, P., "Syncope associated with carbon monoxide poisoning due to narghile smoking," Case Reports in Emergency Medicine 2013: 796857, 2013.
Karaca, Y.; Eryigit, U.; Aksut, N.; Turkmen, S., "Syncope associated with water pipe smoking," BMJ Case Reports [Epub ahead of print], 2013.
Jacob, P.; Abu Raddaha, A.H.; Dempsey, D.; Havel, C.; Peng, M.; Yu, L.; Benowitz, N.L., "Comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking," Cancer Epidemiology, Biomarkers and Prevention [Epub ahead of print], March 5, 2013.
Lee, Y.O.; Mukherjea, A.; Grana, R., "Hookah steam stones: smoking vapour expands from electronic cigarettes to waterpipes,"
Tobacco Control 22 (2): 136-137, March 2013.
Hampson, S.E.; Tildesley, E.; Andrews, J.A.; Barckley, M.; Peterson, M., "Smoking trajectories across high school: sensation seeking and hookah use, " Nicotine and Tobacco Research [Epub ahead of print], January 15, 2013.
Primack, B.A.; Land, S.R.; Fan, J.; Kim, K.H.; Rosen, D., "Associations of mental health problems with waterpipe tobacco and cigarette smoking among college students," Subst.Use.Misuse. [Epub ahead of print], January 10, 2013.
Noonan, D., "A descriptive study of waterpipe smoking among college students," Journal of the American Academy of Nurse Practitioners, 25(1): 11-15, January 2013.
Nguyen, T.; Hlangothi, D.; Martinez, R.A.; Jacob, D.; Anthony, K.; Nance, H.; Saleh, M.A., "Charcoal burning as a source of polyaromatic hydrocarbons in waterpipe smoking," Journal of Environmental Science and Health. Part. B, Pesticides, Food Contaminants, and Agricultural Wastes 48(12): 1097-1102, 2013.
Maher, J.E.; Morris, D.S.; Girard, K.E.; Pizacani, B.A., "Consequences of clean indoor air exemptions in Oregon: the hookah story," Tobacco Control [Epub ahead of print], December 12, 2012.
Brockman, L.N.; Pumper, M.A.; Christakis, D.A.; Moreno, M.A., "Hookah's new popularity among US college students: a pilot study of the characteristics of hookah smokers and their Facebook displays," BMJ Open 2: e001709, December 12, 2012.
Clarke, S.F.; Stephens, C.; Farhan, M.; Ward, P.; Keshishian, C.; Murray, V.; Zenner, D., "Multiple patients with carbon monoxide toxicity from water-pipe smoking," Prehospital and Disaster Medicine 27(6): 612-614, December 2012.
Maziak, W., "The waterpipe: an emerging global risk for cancer," Cancer Epidemiology [Epub ahead of print], November 26, 2012.
Sepetdjian, E.; Halim, R.A.; Salman, R.; Jaroudi, E.; Shihadeh, A.; Saliba, N.A., "Phenolic compounds in particles of mainstream waterpipe smoke," Nicotine and Tobacco Research [Epub ahead of print], November 22, 2012.
Morris, D.S.; Fiala, S.C.; Pawlak, R., "Opportunities for policy interventions to reduce youth hookah smoking in the United States," Preventing Chronic Disease E165, November 2012.
Primack, B.A.; Hopkins, M.; Hallett, C.; Carroll, M.V.; Zeller, M.; Dachille, K.; Kim, K.H.; Fine, M.J., "US health policy related to hookah tobacco smoking," American Journal of Public Health 102(9): e47-e51, September 2012.
Cobb, C.O.; Sahmarani, K.; Eissenberg, T.; Shihadeh, A., "Acute toxicant exposure and cardiac autonomic dysfunction from smoking a single narghile waterpipe with tobacco and with a 'healthy' tobacco-free alternative," Toxicology Letters [Epub ahead of print], October 8, 2012.
Ashurst, J.V.; Urquhart, M.; Cook, M.D., "Carbon monoxide poisoning secondary to hookah smoking," Journal of the American Osteopathic Association 112(10): 686-688, October 2012.
Joseph, S.; Pascale, S.; Georges, K.; Mirna, W., "Cigarette and waterpipe smoking decrease respiratory quality of life in adults: results from a national cross-sectional study," Pulmonary Medicine, 2012.
Jarrett, T.; Blosnich, J.; Tworek, C.; Horn, K., "Hookah use among U.S. college students: results from the National College Health Assessment II," Nicotine and Tobacco Research 14(10): 1145-1153, October 2012.
Cobb, C.O.; Khader, Y.; Nasim, A.; Eissenberg, T., "A multiyear survey of waterpipe and cigarette smoking on a US university campus, " Journal of American College Health 60(7): 521-527, October 2012.
Abughosh, S.; Wu, I.H.; Rajan, S.; Peters, R.J.; Essien, E.J., "Waterpipe smoking among students in one US university: predictors of an intention to quit," Journal of American College Health 60(7): 528-535, October 2012.
Fiala, S.C.; Morris, D.S.; Pawlak, R.L., "Measuring indoor air quality of hookah lounges," American Journal of Public Health [Epub ahead of print], September 20, 2012.
Abughosh, S.; Wu, I.H.; Peters, R.J.; Hawari, F.; Essien, E.J., "Ethnicity and waterpipe smoking among US students," International Journal of Tuberculosis and Lung Disease [Epub ahead of print], September 18, 2012.
Nuzzo, E.; Shensa, A.; Kim, K.H.; Fine, M.J.; Barnett, T.E.; Cook, R.; Primack, B.A., "Associations between hookah tobacco smoking knowledge and hookah smoking behavior among US college students," Health Education Research [Epub ahead of print], September 17, 2012.
Shafique, K.; Mirza, S.S.; Mughal, M.K.; Arain, Z.I.; Khan, N.A.; Tareen, M.F.; Ahmad, I., "Water-pipe smoking and metabolic syndrome: a population-based study," PLoS One 7(7): e39734, July 27, 2012.
Schubert, J.; Heinke, V.; Bewersdorff, J.; Luch, A.; Schulz, T.G., "Waterpipe Smoking: The role of humectants in the release of toxic carbonyls," Archives of Toxicology [Epub ahead of print], June 17, 2012.
Luch, A., "Waterpipe smoking: a new tobacco pandemic entailing severe health risks?," Archives of Toxicology [Epub ahead of print], June 10, 2012.
Primack, B.A.; Shensa, A.; Kim, K.H.; Carroll, M.V.; Hoban, M.T.; Leino, E.V.; Eissenberg, T.; Dachille, K.H.; Fine, M.J., "Waterpipe smoking among U.S. university students," Nicotine and Tobacco Research [Epub ahead of print], May 28, 2012.
Radwan, G.; Hecht, S.S.; Carmella, S.G.; Loffredo, C.A., "Tobacco-specific nitrosamine exposures in smokers and nonsmokers exposed to cigarette or waterpipe tobacco smoke," Nicotine and Tobacco Research [Epub ahead of print], May 9, 2012.
Azab, M.; Khabour, O.F.; Alzoubi, K.H.; Anabtawi, M.M.; Quttina, M.; Khader, Y.; Eissenberg, T., "Exposure of pregnant women to waterpipe and cigarette smoke," Nicotine and Tobacco Research [Epub ahead of print], May 9, 2012.
Noonan, D.; Kulbok, P.A., "Beliefs and norms associated with smoking tobacco using a waterpipe among college students," Journal of Addictions Nursing [Epub ahead of print], April 4, 2012.
Shishani, K.; Roll, J.; Armstrong, M., "Hookah use: going down in smoke," Journal of Addictions Nursing [Epub ahead of print], April 4, 2012.
Rice, V.H.; "Water pipe smoking among the young: the rebirth of an old tradition," Nursing Clinics of North America 47(1): 141-148, March 2012.
Sivilotti, M.L.A.; Abu-Laban, R.B., "Inhaling smoke causes smoke inhalation: put that in your hookah pipe!," Canadian Journal of Emergency 14(1): 3-4, January 1, 2012.
La Fauci, G.; Weiser, G.; Steiner, I.P.; Shavit, I., "Carbon monoxide poisoning in narghile (water pipe) tobacco smokers," Canadian Journal of Emergency Medicine 14(1): 57 - 59, January 1, 2012.
Smith, J.R.; Edland, S.D.; Novotny, T.E.; Hofstetter, C.R.; White, M.M.; Al-Delaimy, W.K.; Lindsay, S.P., "Increasing hookah use in California," American Journal of Public Health [Epub ahead of print], August 18, 2011.

"Waterpipe Tobacco Smoking: General and Specific Populations: Abstract and Introduction: A Systematic Review," BMC Public Health 2011.

Vansickel, A.R.; Shihadeh, A.; Eissenberg, T., "Waterpipe tobacco products: nicotine labelling versus nicotine delivery," Tobacco Control [Epub ahead of print], June 2, 2011.
Lipkus, I.M.; Eissenberg, T.; Schwartz-Bloom, R.D.; Prokhorov, A.V.; Levy, J., "Affecting perceptions of harm and addiction among college waterpipe tobacco smokers," Nicotine and Tobacco Research [Epub ahead of print], April 6, 2011.
Barnett, T.E.; Curbow, B.A.; Soule Jr., E.K.; Tomar, S.L.; Thombs, D.L., "Carbon monoxide levels among patrons of hookah cafes," American Journal of Preventive Medicine 40(3): 324-328, March 2011.
Jamil, H.; Janisse, J.; Fakhouri, M.; Arnetz, J.E.; Arnetz, B.B.; Elsouhag, D., "Do household smoking behaviors constitute a risk factor for hookah use?," Nicotine & Tobacco Research [Epub ahead of print], January 31, 2011.
Blank, M.D.; Cobb, C.O.; Kilgalen, B.; Austin, J.; Weaver, M.F.; Shihadeh, A.; Eissenberg, T., "Acute effects of waterpipe tobacco smoking: a double-blind, placebo-control study," Drug and Alcohol Dependence, [Epub ahead of print], January 28, 2011.
Blosnich, J.R.; Jarrett, T.; Horn, K., "Racial and ethnic differences in current use of cigarettes, cigars, and hookahs among lesbian, gay, and bisexual young adults," Nicotine and Tobacco Research [Epub ahead of print], January 27, 2011.
Fielder, R.L.; Carey, K.B.; Carey, M.P., "Prevalence, frequency, and initiation of hookah tobacco smoking among first-year female college students: a one-year longitudinal study," Addictive Behavior [Epub ahead of print], 2011.
Sepetdjian, E.; Saliba, N.; Shihadeh, A., "Carcinogenic PAH in waterpipe charcoal products," Food and Chemical Toxicology [Epub ahead of print], August 28, 2010.
Raad, D.; Gaddam, S.; Schunemann, H.J.; Irani, J.; Abou Jaoude, P.; Honeine, R.; Akl, E.A., "Effects of waterpipe tobacco smoking on lung function: a systematic review and meta-analysis," Chest [Epub ahead of print], July 29, 2010.

Cobb, C.; Ward, K.D.; Maziak, W.; Shihadeh, A.L.; Eissenberg, T. , "Waterpipe tobacco smoking: an emerging health crisis in the United States, American Journal of Health Behavior 34(3): 275-285, May-June 2010.

Dugas, E.; Tremblay, M.; Low, N.C.; Cournoyer, D.; O'Loughlin, J., "Water-pipe smoking among North American youths," Pediatrics [Epub ahead of print], May 10, 2010.
Jamil, H.; Elsouhag, D.; Hiller, S.; Arnetz, J.E.; Arnetz, B.B., "Sociodemographic risk indicators of hookah smoking among white Americans: a pilot study," Nicotine and Tobacco Research [Epub ahead of print], March 22, 2010.
Rastam, S.; Li, F.-M.; Fouad, F.M.; Al Kamal, H.M.; Akil, N.; Al Moustafa, A.-E., "Water pipe smoking and human oral cancers," Medical Hypotheses 74(3): 457-459, March 2010.
Daher, N.; Saleh, R.; Jaroudi, E.; Sheheitli, H.; Badr, T.; Sepetdjian, E.; Al Rashidi, M.; Saliba, N.; Shihadeh, A., "Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: sidestream smoke measurements and assessment of second-hand smoke emission factors," Atmospheric Environment 44(1): 8-14, January 1, 2010.
Noonan, D., "Exemptions for hookah nars in clean indoor air legislation: a public health concern, Public Health Nursing 27(1): 49-53, January 2010.
Aljarrah, K.; Ababneh, Z.Q.; Al-Delaimy, W.K., "Perceptions of hookah smoking harmfulness: predictors and characteristics among current hookah users," Tobacco Induced Diseases 5(1): 16, December 18, 2009.
Eissenberg, T.; Shihadeh, A., "Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure," American Journal of Preventive Medicine 37(6): 518-523, December 2009.
Maziak, W.; Rastam, S.; Ibrahim, I.; Ward, K.D.; Shihadeh, A.; Eissenberg, T., "CO exposure, puff topography, and subjective effects in waterpipe tobacco smokers," Nicotine and Tobacco Research [Epub ahead of print], May 6, 2009.

Tavafian, S.S.; Aghamolaei, T.; Zare, S., "Water pipe smoking and health-related quality of life: a population-based study," Archives of Iranian Medicine 12(3): 232-237, May 2009.

Grekin, E.R.; Ayna, D., "Argileh use among college students in the United States: an emerging trend," Journal of Studies on Alcohol and Drugs 69(3): 472-475, May 2008.
Maziak, W.; Rastam, S.; Ibrahim, I.; Ward, K.D.; Eissenberg, T., "Waterpipe-associated particulate matter emissions," Nicotine and Tobacco Research 10(3): 519-523, March 2008.
Smith-Simone, S.; Maziak, W.; Ward, K.D.; Eissenberg, T., "Waterpipe tobacco smoking: knowledge, attitudes, beliefs, and behavior in two U.S. samples," Nicotine and Tobacco Research: 10(2): 393-398, February 2008.
Neergaard, J.; Singh, P.; Job, J.; Montgomery, S., "Waterpipe smoking and nicotine exposure: a review of the current evidence," Nicotine and Tobacco Research 9(10): 987 - 994, October 2007.